Active NPI
Hy-Vee Inc
Doing business as Hy-Vee Pharmacy (1417)
- Community/Retail Pharmacy
- Mount Ayr, IA
National Provider Identifier
1972068039
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- Legal business name
- HY-VEE INC
- Doing business as
- Hy-Vee Pharmacy (1417)
- Practice address
- 201 N Fillmore St
Mount Ayr, IA 50854-1627 - Phone
- (641) 464-3300
- Fax
- (641) 464-3303
- NPI assigned
- Feb 4, 2019
- Last updated
- Apr 25, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Angie Nelson
- Title
- Senior Vice President
- Phone
- (515) 267-2800
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | NU | ||
| Community/Retail Pharmacy | 3336C0003X | NU | Primary |
Addresses
Primary practice location
201 N Fillmore St
Mount Ayr, IA 50854-1627
Mailing address
PO Box 850442
Minneapolis, MN 55485-0442
Phone (515) 453-2796
Other practice location 1
406 S. Hayes Street
Mount Ayr, IA 50854
Phone (515) 267-2800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972068039 | Medicaid | IA |
Other names 1
- Hy-Vee Pharmacy (1417)
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IA
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031230000598 | IA | Part B Supplier - Mass Immunization (Roster Biller Only) | 7416855242 |
This NPI is an additional NPI on the enrollment Practice locations: Albia, IA |
| O20190423002500 | IA | DME Supplier - Pharmacy | 7416855242 | Practice locations: Mount Ayr, IA |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 16D2209764 | Hy-Vee Pharmacy #1417 | Certificate of waiver | Jan 14, 2027 |
Medicare medical equipment & supply locations
| Supplier | Supplies | Medicare assignment |
|---|---|---|
| Hy-Vee Pharmacy (1417) | Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs|Commodes, Urinals, Bedpans|Blood Glucose Monitors/Supplies (Non-Mail Order)|Heat & Cold Applications|Canes and/or Crutches|Walkers|Ostomy Supplies|Urological Supplies|Nebulizer Equipment and/o… | Does not accept assignment |
National Provider Directory
National Provider Directory- Tax ID family
- Hy-Vee Pharmacy 1522
Organizations with this tax ID in the same state 20
This tax ID family is large, so up to 24 of its organizations in the same state are linked here.
-
- Skilled Nursing Facility
- Urbandale, IA
- NPI 1922175611
-
dba Hy-Vee Drugstore Clinic Pharmacy (7007)
- Community/Retail Pharmacy
- Ames, IA
- NPI 1902848229
-
- Pharmacist
- Urbandale, IA
- NPI 1902972847
-
dba Hy-Vee Pharmacy #1 (1092)
- Community/Retail Pharmacy
- Council Bluffs, IA
- NPI 1942239454
Locations
406 S Hayes St
Mount Ayr, IA 50854
Phone (641) 464-3300
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Mount Ayr, IA
- NPI 1770112153
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1549238400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1682380800000",
"number": "1972068039",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 850442",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554850442",
"telephone_number": "515-453-2796"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "201 N FILLMORE ST",
"city": "MOUNT AYR",
"state": "IA",
"postal_code": "508541627",
"telephone_number": "641-464-3300",
"fax_number": "641-464-3303"
}
],
"practiceLocations": [
{
"address_1": "406 S. Hayes Street",
"address_purpose": "LOCATION",
"city": "Mount Ayr",
"state": "IA",
"postal_code": "50854",
"country_code": "US",
"telephone_number": "515-267-2800",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "HY-VEE INC",
"organizational_subpart": "NO",
"enumeration_date": "2019-02-04",
"last_updated": "2023-04-25",
"certification_date": "2023-04-25",
"status": "A",
"authorized_official_last_name": "NELSON",
"authorized_official_first_name": "ANGIE",
"authorized_official_title_or_position": "SENIOR VICE PRESIDENT",
"authorized_official_telephone_number": "515-267-2800"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": "NU",
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1972068039",
"state": "IA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Hy-Vee Pharmacy (1417)",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mount Ayr, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.